The Bee's Knees

First topic message reminder :

Interesting article on Rafa's recuperation
http://www.dailymail.co.uk/sport/tennis/article-2449179/Rafael-Nadal-How-broken-star-rebuilt.html

It is worth reading and discussing, but given some of the information in the article, please post responsibly. The owners of this site can be held legally responsible for the comments of the posters.

@H-n/JHM -

http://www.fawcette.net/2012/02/are-tall-players-taking-over-tennis.html

http://www.nytimes.com/2013/08/25/sports/tennis/growth-in-tennis-tape-measure-is-telling.html?pagewanted=all&_r=0

The tallest I can recall playing against Laver was Pancho at 6'3". There is also Tony Trabert at 6'1".

But I will check.

If we talk about Nadal's left arm (at 6'1") then we should also talk about Laver's left arm (at 5'8") who probably had a comparable arm during his day. Bud Collins called it the 'Godzillian'.

@BS... Rochus did not endear himself to many tennis fans with his brazen accusations.

Getting back to the OP. Let us look at twenty years from now in the future. Nadal's son has both his knees replaced with artificial knees. He calls the trainer, who takes out a drill, a mini-lathe, makes a metal shim, removes one of the balls from the ball bearing in his knee joint and replaces it with a new one. Takes an MTO for this. Nadal Jr beats Djokovic III by 200-198 in a fifth set TB. Once the prosthetic is in place, Nadal Jr can jump 20 ft up in the air, whereas he could only jump 12.375 ft without the replacement.

What is the difference between this, 20+ years hence, and PRP now?

Where is the line between 'artificial' and 'natural'? Is this recovery or enhancement?

Now, let us extend this to natural HGH vs artificial HGH? Why is artificial HGH banned?

I may be wrong LF, but PRP increases the speed to recovery/repair to the point that the knee/elbow is back to what it was before the injury - not better than it 'should' be.
As I say, I could be wrong.

Absolutely JHM, it just catalyses recovery. If you outlaw that you might as well outlaw a host of other medical advances and we go back to treating people with leeches and hot towels. What next, ban massages because they aid recovery too? If these newer advances allow players to extend their careers for longer then what's the problem? It's all relative within their own era and anyone is free to use PRP. Sports and medicine are not mutually exclusive, and anyone gesturing so is highly naive...you can't stop progress in sports science, nor should we. Drug taking is a completely different topic.

Any knock-on HGH produced will be v.negligible, or rather clinically insignificant. It's hardly going to mask the high amounts of HGH that dopers take. There will be loads of other procedures which also have knock-on effects Players using oxygen tents/chambers with their resulting EPO boosts is a much bigger concern IMO.

Sportsmail has spoken to his camp plus several independent medical experts, including an eminent knee surgeon

______________________

Looking at the above comment, they are not saying how much they got from his camp, who exactly they mean by "camp" and they seem to be saying that the majority of the info is sourced from experts, implying people who have no connection with the Nadal camp. It seems to be that there is little new in the article, just existing public knowledge and a bit of speculation. I think it's more of a magazine/feature piece than any real news.

JuliusHMarx wrote:I may be wrong LF, but PRP increases the speed to recovery/repair to the point that the knee/elbow is back to what it was before the injury - not better than it 'should' be.
As I say, I could be wrong.

lydian wrote:Any knock-on HGH produced will be v.negligible, or rather clinically insignificant.

I quoted this earlier...

Doctors Amy Wasterlain and Jason Dragoo found that Human Growth Hormone ‘increases dramatically within the first 24 hours after PRP infiltration’. They said that their trials had shown its effects can include ‘rocketing both anabolic and catabolic growth factor release’. They concluded that ‘our observation of statistically significant increases in multiple growth factors over multiple days after local PRP treatment points to a real systemic effect that cannot simply be ignored.’

If this procedure does increase HGH, no matter whether the source is natural or artificial, it will show up on an ABP.

"Increases dramatically..."  Compared to what?
"Points to a real systemic effect..."  Points to....? Not causes then....?

No evidence or conclusive proof of any CLINICAL, not statistical, significance whatsoever. It's pure bunkum really, nothing more than hyperbolic fingerpointing.

Your word "if" at the end is the most significant word in all that. PRP has been used widely for some years now, not one sportsperson has yet failed a HGH drugs test due to or linked to it.

lydian wrote:"Increases dramatically..."  Compared to what?
"Points to a real systemic effect..."  Points to....? Not causes then....?

No evidence or conclusive proof of any CLINICAL, not statistical, significance whatsoever. It's pure bunkum really, nothing more than hyperbolic fingerpointing.

Your word "if" at the end is the most significant word in all that. PRP has been used widely for some years now, not one sportsperson has yet failed a HGH drugs test due to or linked to it.

Would you care to read the actual paper - http://andreasbjerregaard.files.wordpress.com/2013/04/the-systemic-effects-of-platelet-rich-plasma-injection.pdf

I will just quote the abstract and parts of it for highlighting what the Daily Mail is alluding to.

Background: Platelet-rich plasma (PRP) is an autologous blood product used to treat acute and chronic tendon, ligament, and muscle injuries in over 86,000 athletes in the United States annually. The World Anti-Doping Agency (WADA) banned intramuscular PRP injections in competitive athletes in 2010 because of concerns that it may increase performance-enhancing growth factors. The ban on PRP was removed in 2011 because of limited evidence for a systemic ergogenic effect of PRP, but the growth factors within PRP remain prohibited.

Purpose: To quantify the effect of PRP injection on systemic growth factors with performance-enhancing effects and to identify molecular markers to detect treated athletes.

Study Design: Descriptive laboratory study.

Methods: Six ergogenic growth factors monitored by WADA—human growth hormone (hGH), insulin-like growth factor–1 (IGF-1), insulin-like growth factor binding protein–3 (IGFBP-3), basic fibroblast growth factor (bFGF or FGF-2), vascular endothelial growth factor (VEGF), and platelet-derived growth factor–BB (PDGF-BB)—were measured in 25 patients before (baseline) and at 0.25, 3, 24, 48, 72, and 96 hours after intratendinous leukocyte-rich PRP injection. Eating and exercise were prohibited for 3 hours before testing. Growth factors were quantified by enzyme-linked immunosorbent assay, and the change relative to each patient’s base- line was calculated.

Results: Relative to serum, PRP contained significantly more bFGF (226 vs 5 pg/mL), VEGF (1426 vs 236 pg/mL), and PDGF-BB (26,285 vs 392 pg/mL), but IGF-1 and hGH were not elevated. Serum levels increased significantly for IGF-1 at 24 and 48 hours, for bFGF at 72 and 96 hours, and for VEGF at 3, 24, 48, 72, and 96 hours after PRP injection. Additionally, VEGF was increased in all 25 patients after PRP treatment.

Conclusion: Serum IGF-1, VEGF, and bFGF levels are significantly elevated after PRP injection, supporting a possible ergogenic effect of PRP. An indirect marker for hGH doping, the product of IGFBP-3 3 IGF-1, also significantly increased after PRP. Platelet- rich plasma appears to trigger an increase in circulating growth factors through activating biological pathways rather than by serv- ing as a vehicle for the direct delivery of presynthesized growth factors. Elevated VEGF was observed in all patients after PRP, and >= 88% of patients had elevated VEGF at each time point from 3 to 96 hours after PRP, suggesting that VEGF may be a sen- sitive molecular marker to detect athletes recently treated with PRP.

Clinical Relevance: This is the first and only adequately powered study of the systemic effects of PRP. We present evidence that PRP contains and may trigger systemic increases in substances currently banned in competitive athletes. Finally, we provide evi- dence that VEGF could serve as a useful molecular marker to detect athletes treated with PRP.
Keywords: platelet-rich plasma; athletic performance; human growth hormone; doping in sports; insulin-like growth factor–1; growth factors

From http://www.itftennis.com/media/136270/136270.pdf Section S2...

The following substances and their releasing factors are prohibited:
...
Growth Hormone (GH), Insulin-like Growth Factor-1 (IGF-1), Fibroblast Growth Factors (FGFs), Hepatocyte Growth Factor (HGF), Mechano Growth Factors (MGFs), Platelet-Derived Growth Factor (PDGF), Vascular-Endothelial Growth Factor (VEGF) as well as any other growth factor affecting muscle, tendon or ligament protein synthesis/degradation, vascularisation, energy utilization, regenerative capacity or fibre type switching;
and other substances with similar chemical structure or similar biological effect(s).

so nadal openly talks about it eventhough its forbidden and he is not banned . is that it?

naxroy wrote:so nadal openly talks about it eventhough its forbidden and he is not banned . is that it?

It is not forbidden in any way from a WADA standpoint (even though it was in 2009 - as I have documented in my earlier post). And this is not about Nadal alone. The larger context of how far players go and push the boundaries is being lost in this narrow defence of Nadal.

Let us assume that PRP does not enhance performance, but is used for recovery only.

Let me highlight my objection to PRP, in general,...

During last year’s Wimbledon Championships Fernando Verdasco gave an interview to the Wimbledon Live internet channel telling of how he and Nadal had, on occasion, gone through the treatment together which involves spinning blood in a centrifuge and breaking it down.
'They take your own blood, they mix it and take the best part of your own blood, the best cells,' explained Verdasco to Annabel Croft. 'Then they inject it in your tendon. With these injections you recover much faster.'

Is Verdasco injured? (List is here - http://www.matchstat.com/PlayerInjuries/672). Verdasco, unlike Nadal, was not injured for 7+ months, was he?

Does he need this treatment? Who decides that? He quotes - they mix it - with some other chemical or is this a translated version of the word centrifuge?

Is it now fashionable to go through this treatment for faster recovery? Is the ATP Calendar pushing players to the brink of trying such "treatments"?

Murray (as documented by Neil Harman) uses ice baths, while Djokovic uses something else (see his on-court AO interview chastising Hewitt).

I am also aware of the history of Tennis and it's links to Cortisone injections given to players (to manage pain), like Connors, Murray, and others.

Laverfan, where is the interview where Novak chastises Hewitt? I watched it live but its been a while!

CAS wrote:Laverfan, where is the interview where Novak chastises Hewitt? I watched it live but its been a while!

https://www.youtube.com/watch?v=dqFPclGU98E (Start at time index 10:00+).

Thanks Laverfan

LuvSports! wrote:I think its a bit of a joke that this is allowed, then again WADA are a big joke, but what can you do?
It's generally a good indication how the rules aren't keeping pace with developments in the field. PRP "supposedly", and i mean supposedly as this is far from certain, enhances tissue recovery, so does that mean that rafa was injured after all? Who knows.

Also what is dodgy about this is that potentially you can include steroids or hgh in this process and get away with it possibly. I could be wrong but a toronto medicine guy called galea used this and consequently many baseball players were implicated as dopers under his service.
A very tenebrous area to say the least.

Trying to use topical or intraarticular steroids to gain a holistic anabolic effect on the body would be absolutely beyond moronic. The entire purpose of administering steroids topically is that it will not have a body wide effect unless the doses used were gargantuan

laverfan wrote:

naxroy wrote:so nadal openly talks about it eventhough its forbidden and he is not banned . is that it?

It is not forbidden in any way from a WADA standpoint (even though it was in 2009 - as I have documented in my earlier post). And this is not about Nadal alone. The larger context of how far players go and push the boundaries is being lost in this narrow defence of Nadal.

Let us assume that PRP does not enhance performance, but is used for recovery only.

Let me highlight my objection to PRP, in general,...

During last year’s Wimbledon Championships Fernando Verdasco gave an interview to the Wimbledon Live internet channel telling of how he and Nadal had, on occasion, gone through the treatment together which involves spinning blood in a centrifuge and breaking it down.
'They take your own blood, they mix it and take the best part of your own blood, the best cells,' explained Verdasco to Annabel Croft. 'Then they inject it in your tendon. With these injections you recover much faster.'

Is Verdasco injured? (List is here - http://www.matchstat.com/PlayerInjuries/672). Verdasco, unlike Nadal, was not injured for 7+ months, was he?

Does he need this treatment? Who decides that? He quotes - they mix it - with some other chemical or is this a translated version of the word centrifuge?

Is it now fashionable to go through this treatment for faster recovery? Is the ATP Calendar pushing players to the brink of trying such "treatments"?

Murray (as documented by Neil Harman) uses ice baths, while Djokovic uses something else (see his on-court AO interview chastising Hewitt).

I am also aware of the history of Tennis and it's links to Cortisone injections given to players (to manage pain), like Connors, Murray, and others.

if I had to guess I'd assume a doctor...

laverfan wrote:

lydian wrote:"Increases dramatically..."  Compared to what?
"Points to a real systemic effect..."  Points to....? Not causes then....?

No evidence or conclusive proof of any CLINICAL, not statistical, significance whatsoever. It's pure bunkum really, nothing more than hyperbolic fingerpointing.

Your word "if" at the end is the most significant word in all that. PRP has been used widely for some years now, not one sportsperson has yet failed a HGH drugs test due to or linked to it.

Would you care to read the actual paper - http://andreasbjerregaard.files.wordpress.com/2013/04/the-systemic-effects-of-platelet-rich-plasma-injection.pdf

I will just quote the abstract and parts of it for highlighting what the Daily Mail is alluding to.

Background: Platelet-rich plasma (PRP) is an autologous blood product used to treat acute and chronic tendon, ligament, and muscle injuries in over 86,000 athletes in the United States annually. The World Anti-Doping Agency (WADA) banned intramuscular PRP injections in competitive athletes in 2010 because of concerns that it may increase performance-enhancing growth factors. The ban on PRP was removed in 2011 because of limited evidence for a systemic ergogenic effect of PRP, but the growth factors within PRP remain prohibited.

Purpose: To quantify the effect of PRP injection on systemic growth factors with performance-enhancing effects and to identify molecular markers to detect treated athletes.

Study Design: Descriptive laboratory study.

Methods: Six ergogenic growth factors monitored by WADA—human growth hormone (hGH), insulin-like growth factor–1 (IGF-1), insulin-like growth factor binding protein–3 (IGFBP-3), basic fibroblast growth factor (bFGF or FGF-2), vascular endothelial growth factor (VEGF), and platelet-derived growth factor–BB (PDGF-BB)—were measured in 25 patients before (baseline) and at 0.25, 3, 24, 48, 72, and 96 hours after intratendinous leukocyte-rich PRP injection. Eating and exercise were prohibited for 3 hours before testing. Growth factors were quantified by enzyme-linked immunosorbent assay, and the change relative to each patient’s base- line was calculated.

Results: Relative to serum, PRP contained significantly more bFGF (226 vs 5 pg/mL), VEGF (1426 vs 236 pg/mL), and PDGF-BB (26,285 vs 392 pg/mL), but IGF-1 and hGH were not elevated. Serum levels increased significantly for IGF-1 at 24 and 48 hours, for bFGF at 72 and 96 hours, and for VEGF at 3, 24, 48, 72, and 96 hours after PRP injection. Additionally, VEGF was increased in all 25 patients after PRP treatment.

Conclusion: Serum IGF-1, VEGF, and bFGF levels are significantly elevated after PRP injection, supporting a possible ergogenic effect of PRP. An indirect marker for hGH doping, the product of IGFBP-3 3 IGF-1, also significantly increased after PRP. Platelet- rich plasma appears to trigger an increase in circulating growth factors through activating biological pathways rather than by serv- ing as a vehicle for the direct delivery of presynthesized growth factors. Elevated VEGF was observed in all patients after PRP, and >= 88% of patients had elevated VEGF at each time point from 3 to 96 hours after PRP, suggesting that VEGF may be a sen- sitive molecular marker to detect athletes recently treated with PRP.

Clinical Relevance: This is the first and only adequately powered study of the systemic effects of PRP. We present evidence that PRP contains and may trigger systemic increases in substances currently banned in competitive athletes. Finally, we provide evi- dence that VEGF could serve as a useful molecular marker to detect athletes treated with PRP.
Keywords: platelet-rich plasma; athletic performance; human growth hormone; doping in sports; insulin-like growth factor–1; growth factors

Interesting article, and certainly shows evidence that PRP can increase those growth factors. What they now need to do is to follow up the same subjects weeks after the PRP to see what the longer term effects on those levels are

CJ. Are you saying its just moronic for just steroid use? I disagree.

The only benefit (aside from pain relief and reduced inflammation in area administered) would be as a masking agent, allowing the careful use of systemic steroids at a low dose between injections

I agree about the masking agent but why are you so sure it is the only benefit?

In brief, there are 2 reasons we use knee etc injections at all. The fact that they are topical means the dose we give directly goes to the affected area, magnifying their effect in that area. The second reason is related- because of this, and te incomplete perfusion into the blood stream of the steroids, we can give less steroids and thus specifically get fewer and lesser adverse side effects. This is because the steroid injection by its very design is not being spread around into the blood but is remaining in a site which is not isolated by any means but relatively shut off. This immediately reduces the amount of cortisol present in the blood at any time. Now for one thing this reduces the testable levels of steroid, but it also reduces the effective dose and thus any harm/benefit from the steroids systemically, which doping effects would be.

Also, whilst technically anabolic in many areas cortisol is a terrible anabolic steroid- it reduces levels of other endogenous steroids like insulin, it has horrible side effects that would negatively affect any athlete using it and it's not very effective at all for building muscle. It is also almost exclusively the drug administered in IA injections such as Nadal has. It is also related to other more useful steroids but not sufficiently that it would mask their levels.

PRP is more dubious not because it could be masking injections of corticosteroid or even IA injections of anabolics/growth hormones etc, but if the increase in plasma levels of growth factors is used to mask injections of these. IM injections, most likely. However, as most of these growth factors and all steroids by their nature have long term effects, the benefits of raised levels through PRP or the doping masked by PRP would require this to happen over a reasonably long time- weeks to months. That is why I feel the most important question in that PRP paper is how long the systemic effects of PRP last, and how often the athletes receive this treatment. The fact that something as cellular and rich in products as PRP stimulates endogenous production of GFs is in no way surprising but if the production lasted long enough to effectively keep levels raised between doses of PRP, then it should probably be banned/regulated

ChequeredJersey wrote:What they now need to do is to follow up the same subjects weeks after the PRP to see what the longer term effects on those levels are

The subjects were given a single PRP injection as the study mentions.

Although we found that IGF-1 increases less in response to PRP injection (9%) than in response to exogenous hGH doses (.90%),19,27 participants in our study received only a single PRP injection, whereas participants in both of the comparison studies received daily hGH injections for 5 or more days. Overall, our find- ings indicate that PRP triggers a rise in systemic growth factors of similar magnitude to that seen after an acute bout of exercise or a small dose of exogenous hGH.

Typical player treatment is a regular regimen of such injections for a period of time.

ChequeredJersey wrote:if I had to guess I'd assume a doctor...

Why would one need a  doctor for a now legal treatment to write a prescription. I can understand one would be required for administration of the procedure.

laverfan wrote:

ChequeredJersey wrote:What they now need to do is to follow up the same subjects weeks after the PRP to see what the longer term effects on those levels are

The subjects were given a single PRP injection as the study mentions.

Although we found that IGF-1 increases less in response to PRP injection (9%) than in response to exogenous hGH doses (.90%),19,27 participants in our study received only a single PRP injection, whereas participants in both of the comparison studies received daily hGH injections for 5 or more days. Overall, our find- ings indicate that PRP triggers a rise in systemic growth factors of similar magnitude to that seen after an acute bout of exercise or a small dose of exogenous hGH.

Typical player treatment is a regular regimen of such injections for a period of time.

Yes but for how many days after that single injection are levels raised? Just take another blood sample one week after the 96 hours to see what the levels are then. I suspect they would still be significantly raised but whether they are or not is important

laverfan wrote:

ChequeredJersey wrote:if I had to guess I'd assume a doctor...

Why would one need a  doctor for a now legal treatment to write a prescription. I can understand one would be required for administration of the procedure.

Well in this country ( I don't know about Spain), you'd need a doctor to prescribe any treatment involving the administration of drugs as seen in PRP, so someone would have prescribed it to Verdasco

PRP is a well known masking agent for doping.

Of course that does not mean Nadal is doping but I'm not naieve enough to think it's not a possibility. No one is above suspicion, certainly not a player who periodically seems to excel followed by periods of supposed burnout.

 

emancipator

ChequeredJersey wrote:Yes but for how many days after that single injection are levels raised? Just take another blood sample one week after the 96 hours to see what the levels are then. I suspect they would still be significantly raised but whether they are or not is important

I wish the study had a continued followup. It would have been very educational for us.

ChequeredJersey wrote:Well in this country ( I don't know about Spain), you'd need a doctor to prescribe any treatment involving the administration of drugs as seen in PRP, so someone would have prescribed it to Verdasco

In the US, if a medicine is not Over-The-Counter, you would need a prescription too. Assuming that a prescription is required,

a. what would justify one for Nando, and,
b. Nando did not have the Hoffa's Pad issue that Nadal had, so would he really need it?

emancipator wrote:PRP is a well known masking agent for doping.

in 2009, PRP required a TUE. If WADA/ITF were/are so unsure about it and there is lack of scientific data, why not leave it under a TUE, so players who really need it, can get a prescription as necessary and it does not become a Glucose tablet for all and sundry.

emancipator wrote:PRP is a well known masking agent for doping.

Is it 'well-known'? It seems to be so on various forums, but that might just be Chinese whispers writ large.
WADA bans a number of masking agents, but does not ban PRP. If it is a well-known masking agent, like the ones that are banned, why is PRP not banned?

hawkeye wrote:

LuvSports! wrote:I think its a bit of a joke that this is allowed, then again WADA are a big joke, but what can you do?
It's generally a good indication how the rules aren't keeping pace with developments in the field. PRP "supposedly", and i mean supposedly as this is far from certain, enhances tissue recovery, so does that mean that rafa was injured after all? Who knows.

Also what is dodgy about this is that potentially you can include steroids or hgh in this process and get away with it possibly. I could be wrong but a toronto medicine guy called galea used this and consequently many baseball players were implicated as dopers under his service.
A very tenebrous area to say the least.

But it is allowed! Treating injuries or even illness could always be viewed as performance enhancing because it is. So where do you draw the line? You could be draconian and not allow painkillers, surgery or broken bones to be splinted. Or you could just allow anything. But both of these approaches are unsatisfactory. The third way is to get a sporting body to make the rules. But if you do that you have to accept these rules and also accept that sports people need to find ways to recover from injury within these rules.

You hit the nail on the head Hawkeye. Anything that improves recovery, whether it be from injuries, or regular training (don't forget this!), improves performance down the line. Remember: the faster you can recover, the sooner you can train again, and the stronger/fitter you get - the body doesn't just repair itself back to normal, it overcompensates, with the plan the same "injury" will be harder to happen again.

This is why WADA has an impossible job - the options
a) ban anything "unnatural" that that enhances recovery (which isn't practical - e.g., vitamin supplements),
b) you ban nothing (not completely crazy, but never going to happen),
c) you have to draw the line somewhere, which invariably involves arbitrary choices about what is considered cheating.

If it was up to me, I'd only ban substances or procedures that could be shown to cause adverse health effects. I want to see enhanced performances! (but not if its going to mess people up later in life).

So I don't have a problem with PRP (it seems a safe enough procedure), but with the current WADA code it does seem to fall into a grey area (hence all the discussion surrounding it). You can't deny that PRP is a) performance enhancing, and b) is similar to blood doping (which is where most people draw the line): taking your own blood, doing something to it, and injecting it back into your body at a later date.

zaron - if they developed prosthetic legs that could allow people to run 100m in 7 seconds (i.e. enhanced performance), would you watch that 100m race, in preference to the 100m with natural limbs?
Presumably the winner of the former race would largely be determined by the manufacturer, rather than the athlete?

JuliusHMarx wrote:zaron - if they developed prosthetic legs that could allow people to run 100m in 7 seconds (i.e. enhanced performance), would you watch that 100m race, in preference to the 100m with natural limbs?
Presumably the winner of the former race would largely be determined by the manufacturer, rather than the athlete?

They have that, its called cycling.  And they have controls on the specs of the bikes, weight etc, to make things more even.

Or Formula 1. Where the winner often does drive the best car.

But being serious, the answer is no. I'd rather watch the 100m with natural limbs.

I guess the issue you raise with allowing performance enhancing substances is it gives an advantage to the person with the best chemists. But this isn't really about certain substances being "bad", its really an issue of availability. If everyone has access to it, then its a level playing field right?

Take vitamin and mineral supplements - made in the lab and enhance recovery/performance.  Today they are relatively cheap and easily available.  But at some point in the past, they were only available to those with the best chemists...

Zaron are you saying the winner of a race in cycling is determined by the manufacturer rather than the athlete?
Seriously?

LuvSports! wrote:Zaron are you saying the winner of a race in cycling is determined by the manufacturer rather than the athlete?
Seriously?

No. I guess I wasn't being clear.  

I brought up cycling because its a sport where you "add something to your body" to make you go faster. Not as an example of the winner being determined by the manufacturer (it could be, but they put controls on the bike specs to prevent this).  

I gave the example of F1 where "you add something to your body to make you go ALOT faster", as they don't have such strict controls and the winner often does have the fastest car.

Having said this, F1 is more popular than cycling, and maybe athletics too. So maybe people don't really care about a fair contest.

zaron wrote:If everyone has access to it, then its a level playing field right?

No, because those who wish to cheat will either find something no-one else is using and pay to keep it secret or try unproven, potentially dangerous drugs. The black market will always be there.

PRP is used to mask doping and has been for years...

One of it's most prominent practiciners and a pioneering developer of the procedure is a Canadian doctor named Galea.  He treated many famous athletes including Tiger Woods with PRP.. He's also now banned from entering the USA and is convicted HGH doping doctor and smuggler..   You only have to connect the dots.............     A guy famous for treating patients with PRP is also famous for doping those same patients and others...   Did he suddenly develop a conscience and not dope a player while performing a procedure that can mask the very dope he pushes?  Laughable if someone thinks so.

He's back in the news as Alex Rodriguez used collegues of Galea under Galea's direction to dope for years, and Rodriguez in now facing one of the largest MLB bans in history.

It also happens to be that many of the doctors/labs that have been caught doping athletes also are one of the few specialists that can also perform PRP........ a coincidence? smh.

There is a set of logical reasons why human GH behaves the way it does, as a naturally regulated hormone. Once such natural regulation is tinkered with the long-term effects are not very pleasant.

Possible side effects of HGH use include:
nerve, muscle, or joint pain
swelling due to fluid in the body's tissues (edema)
carpal tunnel syndrome
numbness and tingling of the skin
high cholesterol levels
HGH can also increase the risk of diabetes and contribute to the growth of cancerous tumors.  

http://www.webmd.com/fitness-exercise/human-growth-hormone-hgh

Acromegaly results from excessive secretion of growth hormone in adults, usually the result of benign pituitary tumors. The onset of this disorder is typically insideous, occurring over several years. Clinical signs of acromegaly include overgrowth of extremities, soft-tissue swelling, abnormalities in jaw structure and cardiac disease. The excessive growth hormone and IGF-I also lead to a number of metabolic derangements, including hyperglycemia.

http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/gh.html

Micro-dosing can delay the advent of such side effects and not cause overall physiological changes which are significant, but the significant part is what gets debated hotly.

The following text is what boggles my mind...

Even though Platelet Rich Plasma (PRP) contains some growth factors, WADA has clarified that PRP is not prohibited.

http://www.usada.org/prohibited-list/athlete-guide/

... and it required TUEs in 2009. I will speculate that there was much pressure to ignore these and still allow the treatment.

Trusting to Wikipedia here :-

Galea's conviction was for "bringing mislabelled drugs into the United States for the purpose of treating professional athletes." i.e. smuggling. These drugs included HGH.

He was originally also charged with "unlawful distribution of HGH" but was not tried on that offence.

JuliusHMarx wrote:Trusting to Wikipedia here :-

Galea's conviction was for "bringing mislabelled drugs into the United States for the purpose of treating professional athletes." i.e. smuggling. These drugs included HGH.

He was originally also charged with "unlawful distribution of HGH" but was not tried on that offence.

Pretty clear to me that he wasn't mislabeling and smuggling HGH into the country illegally to then treat athletes with it legally :-)...

Yes, and he's recently (currently?) under investigation in Canada for reasons as yet unspecified, as far as I can determine.

JuliusHMarx wrote:Yes, and he's recently (currently?) under investigation in Canada for reasons as yet unspecified, as far as I can determine.

He's part of the Rodriguez and other MLB players case that is currently a huge deal with ARod continuing to play while appealing he suspension and suing MLB. Many players being handed down suspensions and being investigated. Galea supposedly directed or orchestrated much of what went on in the USA with these players.. I guess since he can't travel or practice in USA, he used subordinates.. Since it's ongoing, perhaps that's what the investigation in Canada pertains too.

Along with some of the Spanish doctors- this is one of the, perhaps the #1 PRP doctor in the world-- chosen by people like Tiger who could hire anyone in the world-- and he's a doping doctor.. doping athletes with HGH... which also happens to be perfectly masked with PRP treatments.......... guys-- it's just can't get much clearer than that that PRP is used to dope athletes.

naxroy wrote:some of you guys desire nadal to repeat the armstrong scenario

Well thats the biggest blow to have happened in any sport, this is article is very informative and controversial regarding WADA policies.

May be in the future everybody will adopt a better version of this technique to improve the overall fitness to above inhuman levels, which will result in two different species playing specimens and watching Humans. 

My view is simple, anything that gives somebody advantage over the rest of the field shouldn't be allowed, but end of the day who am I to pass these judgements, I won't be surprised if Murray does something similar to his back and Fed might be pondering why his team of specialists didn't try anything like this to improve his lower back.

invisiblecoolers wrote:

naxroy wrote:some of you guys desire nadal to repeat the armstrong scenario

Well thats the biggest blow to have happened in any sport, this is article is very informative and controversial regarding WADA policies.

May be in the future everybody will adopt a better version of this technique to improve the overall fitness to above inhuman levels, which will result in two different species playing specimens and watching Humans. 

Can't quite imagine different species IC but there is a massive gap now between the top athletes and the watching public compared to 50 years ago. Remember when football players had to have 'proper' jobs as well? And even the top tennis players used to drive themselves around Europe in rented cars.
It's made the sporting excellence on offer much greater, but removed the connection/empathy between fan and athlete somewhat - they're more like Hollywood film stars these days, not some guy you'd meet in a bar.

So exactly who is everyone mad at WADA or anyone who follows their guidance?

If say I was a pro athlete with a bad back I would talk to doctors and ask for advice. Then check with WADA to make sure any treatment was within the rules. Then as long as I was happy with the treatment I would go ahead.

I have never seen this video of PRP being injected into a patient. I find in informative, interesting and can only see it as a medical treatment for a chronic condition. Rafa I know goes to a clinic in Barcelona and has the same doctor for each time he has to have this for his knees.
Please tell me where you can see that it is giving him an advantage over other players when it is purely a medical procedure. Other players I am sure have received the same treatment for shoulder, elbow or even wrist injury. Personally I think it a great innovation and I wish I could have such treatment.

https://www.youtube.com/watch?v=RsT6SB1q2vA

I don't think anyone is complaining about the athletes using PRP correctly, given it is approved by WADA.

Some people e.g. lavefan disagree with WADA, in that they feel PRP enhances performance and should be banned. I personally think that, used as intended, it simply improves recovery time, which I think is a good thing. However, I am not an expert in it's effects.

Other people e.g. truffin have stated the case that PRP has been mis-used by athletes to cover illegal HGH treatment. The examples given do not include tennis players, I believe, but one then has to think about the overall scenario and draw one's own individual conclusions, which will rightfully and respectfully differ from person to person.

So we are now putting doctors who administer this procedure under suspicion. How sad that it has come to that .. that given some of the serious injuries that players of any sport are prone to even the medical treatment they receive under controlled conditions is considered to be suspect....  

One of the doctors isn't just under suspicion - he was convicted of trying to smuggling illegal HGH into the USA. That was the doctor that treated Tiger Woods, so it wasn't just some quack.

Edit - extrapolate that. We know Dr Galea treated Tiger with PRP. We know Dr. Galea tried to smuggle illegal HGH into the USA. We know that PRP has been mis-used to cover up illegal HGH treatment. Now consider the difference between a Tiger fan and a neutral person in the way they react to that information. A Tiger fan will quite rightly argue there is no proof of anything. A neutral person will quite rightly have suspicions.

JuliusHMarx wrote:

invisiblecoolers wrote:

naxroy wrote:some of you guys desire nadal to repeat the armstrong scenario

Well thats the biggest blow to have happened in any sport, this is article is very informative and controversial regarding WADA policies.

May be in the future everybody will adopt a better version of this technique to improve the overall fitness to above inhuman levels, which will result in two different species playing specimens and watching Humans. 

Can't quite imagine different species IC :)but there is a massive gap now between the top athletes and the watching public compared to 50 years ago. Remember when football players had to have 'proper' jobs as well? And even the top tennis players used to drive themselves around Europe in rented cars.
It's made the sporting excellence on offer much greater, but removed the connection/empathy between fan and athlete somewhat - they're more like Hollywood film stars these days, not some guy you'd meet in a bar.

The gap is just getting bigger and bigger JHM, medical sciences are abused by professional athletes to gain that extra advantage over fellow colleagues, rather than competiting against each others game modern day sportsman compete against each others technology, really sad for all sports. 

Haddie-nuff wrote:So we are now putting doctors who administer this procedure under suspicion. How sad that it has come to that .. that given some of the serious injuries that players of any sport are  prone to even the medical treatment they receive under controlled conditions is considered to be suspect....  

Well there were several doctors involved in Louis Ams case  , science and medical can be used as well as abused.

Haddie-nuff wrote:So we are now putting doctors who administer this procedure under suspicion. How sad that it has come to that .. that given some of the serious injuries that players of any sport are  prone to even the medical treatment they receive under controlled conditions is considered to be suspect....  

Doctors without morals, who do not fulfill their Hippocratic oath are no doctors. You are confusing doctors that helped with surgery on your dear husband with a group of doctors like Ferrari, Galea, Fuentes, del Moral, the BALCO doctors, the East German team of doctors who treated children like Kornelia Ender and many others, and then went to China to continue their methods without an iota of compassion or morals or guilt.

Should I quote the further darker side of the medical profession and what was done to people during many wars?

Nadal in his biography says, that professional sport is bad for public health, yet it is a magnet for attracting money by the billions.

This may well be the case for some but the reverse of this is to withold treatment from a patient which you know will ease pain and suffering is also in breach of the Hippocratic oath. It is a doctor´s duty to use whatever treatment is available to the benefit of that patient.. whether he be a sportsman or no. I see no wrong in the treratment whcih Nadal and I daresay others have. I cannot believe that a doctor would not know if a patient was using drugs as it would show in the inevitable blood tests that they must receive before such treatment is administered. But to lable all doctors as not having the best interest of their patient at heart and merely an aid to promoting  players to use PEDS is in my opinion quite absurd